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. 2018 Jun;27(6):673-679.
doi: 10.1158/1055-9965.EPI-17-0822. Epub 2018 Mar 12.

Survival among Lung Cancer Patients in the U.S. Military Health System: A Comparison with the SEER Population

Jie Lin  1   2 , Christine Kamamia  3 , Derek Brown  3 , Stephanie Shao  3 , Katherine A McGlynn  4 , Joel A Nations  3 , Corey A Carter  3 , Craig D Shriver  3   2 , Kangmin Zhu  1   5
Affiliations

Survival among Lung Cancer Patients in the U.S. Military Health System: A Comparison with the SEER Population

Jie Lin et al. Cancer Epidemiol Biomarkers Prev. 2018 Jun.

Abstract

Background: The U.S. military health system (MHS) provides universal health care access to its beneficiaries. However, whether the universal access has translated into improved patient outcome is unknown. This study compared survival of non-small cell lung cancer (NSCLC) patients in the MHS with that in the U.S. general population.Methods: The MHS data were obtained from The Department of Defense's (DoD) Automated Central Tumor Registry (ACTUR), and the U.S. population data were drawn from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program. The study subjects were NSCLC patients diagnosed between January 1, 1987, and December 31, 2012, in ACTUR and a sample of SEER patients who were matched to the ACTUR patients on age group, sex, race, and year of diagnosis group with a matching ratio of 1:4. Patients were followed through December 31, 2013.Results: A total of 16,257 NSCLC patients were identified from ACTUR and 65,028 matched patients from SEER. Compared with SEER patients, ACTUR patients had significantly better overall survival (log-rank P < 0.001). The better overall survival among the ACTUR patients remained after adjustment for potential confounders (HR = 0.78, 95% confidence interval, 0.76-0.81). The survival advantage of the ACTUR patients was present regardless of cancer stage, grade, age group, sex, or race.Conclusions: The MHS's universal care and lung cancer care programs may have translated into improved survival among NSCLC patients.Impact: This study supports improved survival outcome among NSCLC patients with universal care access. Cancer Epidemiol Biomarkers Prev; 27(6); 673-9. ©2018 AACR.

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Conflict of interest statement

Conflict of Interest Disclosure: The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Kaplan-Meier Survival Curves for ACTUR and SEER patients with non-small cell lung cancer (NSCLC). Figure 1 shows the comparison of survival probability over time for ACTUR and SEER patients. Patients were diagnosed between 1987 and 2012 and followed through December 31, 2013.
See this image and copyright information in PMC

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